Most Frequently Asked Questions: Heat vs. Ice

“Do I use ice or heat, doc?”

This is a question I get day after day in my practice. First let’s simplify and look at what effects ice and heat have on the body.


-opens up blood vessels

-increases blood flow

-relaxes muscles

-alleviates pain


-slows down blood flow to the injury

-reduces swelling

-reduces inflammation

-alleviates pain

The bottom line is that both heat and ice CAN reduce pain. The variable is your injury/condition, and deciding which option is right for you.

For the most part when a person first comes in to my office, they are in acute pain. Generally, the injury has just happened and they are experiencing some swelling/inflammation. For these patients I suggest ice. Ice will reduce the influx of blood flow to the injury. This will reduce swelling and inflammation which in turn causes pain.

Chronic pain is a different story. For this type of pain I suggest a combination of both. Morning Heat, and Evening Ice.

The most common chronic pain I deal with day to day in my practice is low back pain. These patients usually complain of pain and stiffness in the morning that gets better throughout the day.

Overnight is when our bodies do restoration/repair. As this process begins, inflammation and swelling increase around areas of weakness/dysfunction. Muscles tighten up as they become compressed by swelling and inflammation.

Thus so, when you wake up in the morning the swelling and inflammation cause you to feel tight and stiff. For this reason I suggest morning heat and stretching. This will open up the blood vessels, relax muscles and reduce inflammation and swelling.


When you go throughout your day, moving your body will naturally be doing this. As you go to work, run errands, play with your kids, etc., you reduce inflammation and swelling which in turn alleviates your pain. This is why patients say they get better as the day goes on.


At night, for chronic conditions, I suggest Ice. Ice slows down the blood flow, reduces swelling and reduces inflammation. Ice gives your body a head start to ward off the swelling and inflammation that happens at night while our bodies repair.





Dr Caitlin
Dr. Caitlin Pietrosanto is a graduate of D'Youville College of Buffalo NY. There she obtained her Doctorate of Chiropractic and Bachelor Degree in Biology. She has completed extensive post-graduate training in Spidertech Taping, Graston technique and is a licensed Doctor of Chiropractic in The State of New York. Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints such as back pain, neck pain, pain in the extremities ,and headaches. When other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition using physiotherapy techniques. These techniques are focused on restoring the structure and function of affected muscle and tissue.

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